Rectal cancer treatment options consist mainly of surgical therapy, radiation therapy, chemotherapy, and targeted therapies. The treatments may have different objectives, depending on the treatment chosen and the stage of the cancer. But in most cases, the goal is to allow the doctor to:
- Cure the cancer by removing all cancer cells
- Prevent cancer to grow and spread
- Reduce the risk of recurrence
- Reduce or eliminate the side effects caused by the cancer treatment itself
- Improve the comfort and quality of life of the patient from the cancer symptoms such as pain.
Depending on the stage of the tumor in the rectum, one type of treatment is necessary. In other cases where the cancer is aggressive and advanced, a combination of treatments is needed to better control the disease. It is thus possible for a surgeon to perform a surgery and then give acomplete treatment with chemotherapy to the patient.
Additional treatment, adjuvant therapy, can be performed in order to supplement the action of the main treatment and enhance its effectiveness.
The choice of treatment which is best suitable for the situation of the patient is usually discussed at a multidisciplinary meeting where many health professionals of different specialties meet to discuss the best treatment possible. They can also offer the patient to participate in a clinical trial. Most of the times, the team includes professionals from these specialties: gastroenterologist, medical oncologist, radiation oncologist, surgeon, pathologist, psychologist orpsychiatrist, pain specialist, nurse, stoma, dietitian, social worker.
Surgical Therapy– Rectal cancer treatment is mainly based on surgery that aims to cure the cancer by removing the portion of the rectum affected by the tumor. The challenge is to remove the tumor with clear margins and preserve, if possible, the anal sphincter, which is important to avoid bowel incontinence. The operation requires a hospital stay of seven to ten days on average. Side effects related to the surgery can persist for several weeks after the procedure.They must be reported by the patient and be systematically supported.
The tumor and all tissues removed during operation subject to a histopathological examination. This test is designed to determine the extent of the disease and whether further treatment is necessary after surgery.
Radiation Therapy– radiotherapy is often associated with surgery in rectal cancer treatment. When radiation therapy is indicated, it is most often performed before surgery to reduce the sizeof the tumor in order to facilitate surgical removal. In this case, radiation is frequently associatedto chemotherapy. In rare cases the radiation therapy can be used after surgery to reduce therisk of local recurrence.
Chemotherapy – When chemotherapy is given to rectal cancer patients, it is often used before surgery to enhance the action of the radiation. When performed after surgery, its goal is toreduce the risk of distant recurrence, given chemotherapy is a systematic treatment which affects all organs in the body.
But this is not all. All these therapies may not be enough for a complete recovery. Management of cancer is comprehensive and includes all the care and support the patient mayneed at diagnosis, during and after treatment: psychological support for the patient and his family, social support, management of pain, education on nutrition, financial support, and others. All these criteria are important to help the patient completely recover.